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. 2022 Jul 6;152(7):1747-1754.
doi: 10.1093/jn/nxac082.

Acculturation and Associations with Ultra-processed Food Consumption among Asian Americans: NHANES, 2011-2018

Krithi Pachipala  1 , Vishal Shankar  1 , Zachary Rezler  1 , Ranjana Vittal  1 , Shahmir H Ali  2 , Malathi S Srinivasan  1 , Latha Palaniappan  1 , Eugene Yang  1   3 , Filippa Juul  4 , Tali Elfassy  1   5
Affiliations

Acculturation and Associations with Ultra-processed Food Consumption among Asian Americans: NHANES, 2011-2018

Krithi Pachipala et al. J Nutr. .

Abstract

Background: Ultra-processed food (UPF) consumption is linked to adverse health outcomes, including cardiovascular disease and all-cause mortality. Asian Americans (AAs) are the fastest growing ethnic group in the United States, yet their dietary patterns have seldom been described.

Objectives: The aim was to characterize UPF consumption among AAs and determine whether acculturation is associated with increased UPF consumption.

Methods: The NHANES is an annual, cross-sectional survey representative of the US population. We examined 2011-2018 NHANES data, which included 2404 AAs ≥18 y old with valid 24-h dietary recall. Using day 1 dietary recall data, we characterized UPF consumption as the percentage of caloric intake from UPFs, using the NOVA classification system. Acculturation was characterized by nativity status, nativity status and years in the United States combined, home language, and an acculturation index. We assessed the association between acculturation and UPF consumption using linear regression analyses adjusted for age, sex, marital status, education, income, self-reported health, and self-reported diet quality.

Results: UPFs provided, on average, 39.3% (95% CI: 38.1%, 40.5%) of total energy intake among AAs. In adjusted regression analyses, UPF consumption was 14% (95% CI: 9.5%, 17.5%; P < 0.05) greater among those with the highest compared with the lowest acculturation index score, 12% (95% CI: 8.5%, 14.7%: P < 0.05) greater among those who speak English only compared with non-English only in the home, 12% (95% CI: 8.6%, 14.7%: P < 0.05) greater among US-born compared with foreign-born AAs, and 15% (95% CI: 10.7%, 18.3%: P < 0.05) greater among US-born compared with foreign-born AAs with <10 y in the United States.

Conclusions: UPF consumption was common among AAs, and acculturation was strongly associated with greater proportional UPF intake. As the US-born AA population continues to grow, UPF consumption in this group is likely to increase. Further research on disaggregated AA subgroups is warranted to inform culturally tailored dietary interventions.

Keywords: Asian Americans; NHANES; acculturation; diet; nutrition; ultra-processed food.

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Figures

FIGURE 1
FIGURE 1
Distribution of percentage of total calories derived from UPFs among Asian Americans, NHANES 2011–2018. UPF, ultra-processed food.
FIGURE 2
FIGURE 2
Survey-weighted mean percentage of total calories derived from UPFs by (A) sociodemographic, (B) socioeconomic, and (C) self-reported health measures among non-Hispanic Asian American adults from the NHANES, 2011–2018. The numbers within each figure bar represent the n per group. Ref, reference; UPF, ultra-processed food. *Indicates estimate is significantly different (p < 0.05) compared to the reference category.
FIGURE 3
FIGURE 3
Survey-weighted mean percentage of total calories derived from UPFs by acculturation measures among non-Hispanic Asian American adults from the National Health and Examination Survey (NHANES), 2011–2018. The numbers within each figure bar represent the n per group. Acc, Acculturation; Ref, reference; UPF, ultra-processed food. *Indicates estimate is significantly different (p < 0.05) compared to the reference category.
See this image and copyright information in PMC

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